Maternity Insurance

In this section, we will try to understand the concept of 'Maternity Insurance' which most Indians are unaware of. Not because it is a novel concept, but because people in the country deem insurance as a cover that secures against death, disability and disease. Maternity insurance is just like any other insurance product and covers the expenses on childbirth up to a certain limit. Customers interested in buying it can either pay for it as a standalone policy or choose the same as an add-on cover to the existing health insurance plan by agreeing to pay an added premium amount.

To understand how Maternity Insurance works, let us look at the following example:

Vivek Singhal and his wife Ishita had been married for the past two years. They are now planning for a family and are looking at possible expenses that would have to be met during delivery and childbirth.

Vivek’s father Subodh recently shared the good news of becoming a father and how his wife had to undergo a cesarean to deliver the baby. The total hospital expenses had amounted to ₹1,60,000. Vivek was concerned about the high maternity costs and subsequent medical care. It is then that Subodh informed Vivek about maternity insurance plans and how they serve to downplay the impact of inflation on medical costs. Subodh informed about how he and his wife had made plans for the child’s delivery by choosing a maternity plan beforehand that also includes health insurance benefits for infants too.

Vivek and his wife, however, continued to be unsure about the concept of maternity insurance and decided to look for details on the web.

How Maternity Insurance Works?

Medical expenses are increasing each year. This includes consultation fees, hospitalisation expenses, costs of medicines and expenses on various surgeries. Complicated surgeries cost more than others. This holds true for hospitalisation expenses during childbirth, especially, if there are complications involved during child deliveries. Most hospitals charge between ₹50,000 to ₹2,00,000 depending on the facilities and the nature of treatment during the childbirth process. Buying a maternity insurance plan in advance helps pay for the childbirth expenses in addition to the amount expended on the baby’s healthcare subject to the condition that hospital charges do not exceed the sum assured amount. This helps alleviate the financial burden that many families face while making payments towards the hospital bills.

When Should You Opt For Maternity Insurance?

No insurance company will grant you maternity cover once you are pregnant. Ideally, the best time to seek maternity cover is before you conceive. While buying any maternity insurance policy, it is important that you read the policy details carefully, especially those that relate to the waiting period before pregnancy. Many insurance companies mandate a waiting period of three to four years before the insured can claim the benefits of the policy.

It is rightly said that the principle underlying the maternity insurance concept is proper family planning as opposed to sudden and unexpected pregnancies.

What Does Maternity Insurance Cover?

Most maternity plans sold by insurance companies in India cover:

One month’s pre-hospitalisation expenses and two months’ post-hospitalisation costs
Delivery expenses irrespective of normal childbirth or delivery through C-section
Expenses on hospitalisation including doctors’ fees, nursing expenses, room rent, surgery costs and anaesthetist’s fees
Charges of daycare treatment
Vaccination charges of the newborn infant
Ambulance charges for carrying the mother to the hospital for delivery
Cashless facility in network hospitals

Maternity Insurance Does Not Cover

Though maternity plans cover pre-hospitalisation expenses, it does not pay for treatment of disorders existing prior to the pregnancy of the insured. Treatment of infants born with congenital defects is not covered under any maternity plan. Any expenses made on medicines or procedures outside the purview of treatment will not be considered a valid claim. Routine visits to the doctor for checkups and consultation fees after two months of the child’s delivery will not be considered as a part of the maternity insurance claim.